手术对颞叶癫痫病人认知功能的影响

Effect of surgery on cognitive function of patients with temporal lobe epilepsy

目的探讨手术对颞叶癫痫病人认知功能的影响。方法回顾性分析2017年1月至2020年1月手术治疗的60例颞叶癫痫的临床资料。38例采用前颞叶切除术(ATL)治疗,22例采用选择性海马杏仁核切除术(SAH)治疗。术后6个月,采用Engle分级评估预后。术前、术后6个月由专业人员采用面对面形式完成认知功能评估,采用韦氏智力测验量表测试智商;术前记忆量表甲套+术后乙套测验记忆功能,采用记忆商数(MQ)评估记忆功能。结果术后6个月,Engle分级Ⅰ级35例,Ⅱ级20例,Ⅳ级5例。术后6个月,两组MQ和智商均明显增高(P<0.05),而且,SAH组术后MQ明显高于ALT组(P<0.05)。结论手术治疗可以改善颞叶癫痫病人的智商和记忆功能,SAH优于ATL。

Objective To evaluate the effect of surgery on the cognitive function of the patients with temporal lobe epilepsy(TLE).Methods A retrospective analysis was performed on the clinical data of 60 patients with TLE who underwent surgical treatment from January 2017 to January 2020.Of 60 TLE patients,38 patients received anterior temporal lobectomy(ATL) and 22 patients received selective amygdalo-hippocampectomy(SAH).The Engle class was used to assess the outcomes 6 months after the operation.Memory quotient(MQ) and intelligence quotient(IQ) were measured by adult Wechsler Memory Scale and adult Wechsler Intelligence Scale before surgery and 6 months after surgery,respectively.Results Six months after the operation,Engle class Ⅰ was achieved in 35 patients,class Ⅱ in 20 and class Ⅳ in 5.Both MQ and IQ were significantly higher after the surgery than those before the surgery in both groups(P<0.05).Moreover,the MQ of patients in SAH group was significantly higher than that of patients in ATL group(P<0.05).Conclusions Surgical treatment improves IQ and MQ of the TLE patients.The effect of SAH on MQ of TLE patients was better than that of ATL.